NOTICE, OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />DATE: TIME: / -2 ! 1 5 Prv) CASE # <br />LOCATION 1PARK/0PFN SPACE): E <br />3 <br />V <br />11 1111 111pl 11!11�11' 111111111111 111111111 !1! 11 <br />I <br />The basis for this Notice of Restriction of Use is that on you violated Section J P41 cat` the Park <br />and Open Space Rules, and/or Section o the Eugene Code, 1371, and/or O R S 'SOY . TO wit, youj�4 <br />Pursuant to Park and OpenSpacc Rule R= you are entitled to an informal hearing to contest this Notice. A request for an <br />informal hearing must be inade in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive. of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene{ OR <br />97402. <br />The Division Director shall schedule a time and place for the infix al hearing to be conducted, which shall be not rnore than <br />72 hours (exclusive, of weekends) o receipt of the request for hearin At the informal hea ring the Division D irector wi on ly <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearing, <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at tliedate and time shown above <br />(Signature of person issuing/delivering notioe) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />being issued the nofice <br />White Copy; Public Work, Given Copyt File Yphuw Copy: Report Copy Pink Copy! Recipient G ild C upv: 0 ffiN cer Appea I i aofice Rev, 04103 <br />Name: Last First Middle <br />DOB: <br />Racc- 'ex: <br />Res- Address City St ate Zip <br />Res, Phom <br />Work Plione: <br />V <br />11 1111 111pl 11!11�11' 111111111111 111111111 !1! 11 <br />I <br />The basis for this Notice of Restriction of Use is that on you violated Section J P41 cat` the Park <br />and Open Space Rules, and/or Section o the Eugene Code, 1371, and/or O R S 'SOY . TO wit, youj�4 <br />Pursuant to Park and OpenSpacc Rule R= you are entitled to an informal hearing to contest this Notice. A request for an <br />informal hearing must be inade in writing and filed with the Parks & Open Space Division Director ("the Division Director") <br />within 48 hours (exclusive. of weekends) of receipt of this Notice at the following address: 1820 Roosevelt, Blvd., Eugene{ OR <br />97402. <br />The Division Director shall schedule a time and place for the infix al hearing to be conducted, which shall be not rnore than <br />72 hours (exclusive, of weekends) o receipt of the request for hearin At the informal hea ring the Division D irector wi on ly <br />consider testimony from you, City personnel involved in the incident that resulted in this Notice, and other witnesses to the <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hearing, <br />This Notice shall remain in effect pending any requested hearing. <br />This Notice of Exclusion was delivered to the person named at the top of this Notice at tliedate and time shown above <br />(Signature of person issuing/delivering notioe) <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above. <br />being issued the nofice <br />White Copy; Public Work, Given Copyt File Yphuw Copy: Report Copy Pink Copy! Recipient G ild C upv: 0 ffiN cer Appea I i aofice Rev, 04103 <br />